Lifetime Suicidal Behaviors and Career Characteristics Among U.S. Army Soldiers: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

Abstract

The current report presents data on lifetime prevalence of suicide ideation and nonfatal attempts as reported by the large representative sample of U.S. Army soldiers who participated in the Consolidated All-Army Survey of the Army Study to Assess Risk and Resilience in Servicemembers (N = 29,982). We also examine associations of key Army career characteristics with these outcomes. Prevalence estimates for lifetime suicide ideation are 12.7% among men and 20.1% among women, and for lifetime suicide attempts are 2.5% and 5.1%, respectively. Retrospective age-of-onset reports suggest that 53.4%-70% of these outcomes had preenlistment onsets. Results revealed that, for both men and women, being in the Regular Army, compared with being in the National Guard or Army Reserve, and being in an enlisted rank, compared with being an officer, is associated with increased risk of suicidal behaviors and that this elevated risk is present both before and after joining the Army.

Prior Mental Disorders and Lifetime Suicidal Behaviors Among US Army Soldiers in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

“…Consistent with previous STARRS reports (Millner et al., ), odds of postenlistment suicide attempts in models that do not control for mental disorders are significantly higher for Regular Army than activated National Guard or Army Reserve soldiers among both men and women (OR = 3.4–3.8) and unrelated to the broad MOS categories considered here (Table , Model 1). Among men, junior enlisted soldiers have elevated odds of suicide attempt compared to officers (OR = 3.9) and currently deployed soldiers have elevated odds of first suicide attempts while deployed (OR = 1.9) compared to never‐deployed men.…”

“…As previously reported (Millner et al., ), lifetime prevalence of attempted suicide in the total sample is 2.5% among men and 5.1% among women, with 57.3%–64.3% (men–women) of these respondents reporting that their first suicide attempt occurred before they enlisted in the Army (Table ). Decomposition shows that 41.8%–46.1% of men–women with suicide ideation develop a plan, 33.9%–38.3% of men–women with a plan make an attempt, and 9.2%–14.8% of men–women with suicide ideation but no plan make a suicide attempt.…”

“… The pre‐ and postenlistment proportions shown here differ slightly from those presented in a prior paper using these data (Millner et al., ) because age of enlistment was amended in this paper to reflect administrative data when the age at survey did not coincide with the birth date in Army records. The resulting changes are minimal as they involved only: n = 14 attempts (1.7% of total attempts), n = 84 ideators (2.1% of total ideators), n = 38 planners (2.6% of total planners), n = 11 planned attempts (2.1% of total planned attempts), n = 3 unplanned attempts (1.1% of total unplanned attempts). …”

“…Additionally, substantial percentages of soldiers experience the onset of suicide ideation, plans, and attempts as well as mental disorders, both before and after enlistment. Although prior reports have highlighted the noteworthy rates of preenlistment suicidal behaviors (Millner et al., ; Nock et al., ), it is also significant to note that nearly one‐third to almost one‐half of suicidal thoughts and behaviors have their onset postenlistment. Furthermore, onsets of most mental disorders occur for more soldiers during postenlistment, compared with preenlistment.…”

“…In an initial paper describing this sample, we reported on the pre‐ and postenlistment prevalence of suicidal behaviors as well as their associations with Army career characteristics (e.g., Regular Army versus G/R, rank, occupation; Millner et al., ). Here, we expand on that work by examining the role of both pre‐ and postenlistment mental disorders in predicting the subsequent onset of suicidal behaviors as of the time of the AAS survey.…”